Please consider becoming a Donor, Sponsor, Benefactor, Patron, or Angel to help underwrite the costs of this series. For a donation of $150 - $249, Donors will receive one ticket to the concert. Sponsors, for a donation of $250 - $499, will receive two tickets to the concert, Benefactors, for a donation of $500 - $999, will receive four tickets to the concert, Patrons, for a donation of $1000 - $4999, will receive six tickets to the concert, and Angels, for a donation of $5000 or more, will receive eight tickets to the concert. Names of Donors, Sponsors, Benefactors, Patrons, and Angels will be listed in the programs if so desired.

American-Japanese Cultural Concert Series

I/We would like

____To be a Donor of the American-Japanese Cultural Concert Series @ $150 - $249

____To be a Sponsor of the American-Japanese Cultural Concert Series @ $250 - $499

____To be a Benefactor of the American-Japanese Cultural Concert Series @ $500 - $999

____To be a Patron of the American-Japanese Cultural Concert Series @ $1000 - $4999

____To be an Angel of the American-Japanese Cultural Concert Series @ $5000 or more

Enclosed please find a check for _____________ made payable to the American-Japanese Cultural Concert Series, Inc.

All tickets will be held at the door. You may choose the concert(s) you would like to attend at any time (617-721-5105 or wkboston@live.jp or indicate on the back of this form).

Name________________________________________________________________

Address______________________________________________________________

Telephone____________________________________________________________

____Please list my name in the programs as follows:___________________________________